Electromagnetic fields and epidemiology: An overview inspired by the fourth course at the International School of Bioelectromagnetics

The association between incidence and mortality of brain cancer and human development index (HDI): an ecological study

Background

Brain cancer is a rare and deadly malignancy with a low survival rate. The present study aims to evaluate the epidemiology of brain cancer and its relationship with the human development index (HDI) worldwide.

Methods

This is an ecological study. The data on cancer incidence and cancer mortality was extracted from the World Bank for Cancer in 2018 (GLOBOCAN 2018). The incidence, mortality rate, and brain cancer distribution maps were drawn for different countries. We used correlation and regression tests to examine the association of incidence and mortality rates of brain cancer with HDI. The statistical analysis was carried out by Stata-14 and a significance level of 0.05 was considered.

Results

According to the results of Global Cancer Registry in 2018, there were 18,078,957 registered cases of cancer in both sexes, of which 29,681 were related to brain cancer. The highest incidence (102,260 cases, 34.4%) and mortality (77,815 cases, 32.3%) belonged to very high HDI regions. Results showed that incidence (r = 0.690, P < 0.0001) and mortality rates (r = 0.629, P < 0.001) of brain cancer are significantly correlated with HDI. We also observed a positive correlation between brain cancer incidence and Gross National Income (GNI) (r = 0.346, P < 0.001), Mean Years of Schooling (MYS) (r = 0.64, P < 0.001), TABLE (LEB) (r = 0.66, P < 0.001) and Expected Years of Schooling (EYS) (r = 0.667, P < 0.001). Results also revealed that mortality rate was significantly correlated with GNI (r = 0.28, P < 0.01), MYS (r = 0.591, P < 0.01), LEB (r = 0.624, P < 0.01), and EYS (r = 0.605, P < 0.01).

Conclusion

The results of the study showed that the incidence and mortality of brain cancer in countries with higher HDI levels is higher than countries with lower HDI levels, so attention to risk factors and action to reduce it in countries with higher HDI levels in controlling this cancer in this Countries are effective.

Exposure to Electromagnetic Fields of High Voltage Overhead Power Lines and Female Infertility

Background:

Living in the vicinity of high voltage power lines has brought about a range of health woes, but the effect of residential exposure to electromagnetic fields from the power lines on female fertility has not been explored yet.

Objective:

To test the hypothesis if residential proximity to high voltage power lines could be associated with the increased risk of female infertility.

Methods:

In a case-control study, 462 women with confirmed diagnosis of unexplained infertility or behavioral and environmental factors were assessed between February 2014 and December 2016. Control group comprised of 471 persons with no history of infertility selected using randomized-digit dialing from the numbers registered in a birth registry between 2014 and 2016. The nearest linear distance from high voltage power lines to the participants' residence of cases and controls was measured using a Geographical Information System (GIS) and Google Earth aerial evaluation for high voltage power lines (240–400 kV).

Results:

112 (14.1%) houses were within 500 meters from a high voltage power line. Women living within 500 meters of the lines (OR 4.14, 95% CI 2.61 to 6.57) and 500–1000 meters of the line (OR 1.61, 95% CI 1.05 to 2.47) carried a significantly higher risk of infertility than those women living more than 1000 meters away from the power lines. After adjusting for confounding factors, women living within 500 meters of the lines carried a higher risk (aOR 4.44, 95% CI 2.77 to 7.11) of infertility compared with women living more than 1000 meters of the lines.

Conclusion:

The current safety guidelines for electromagnetic fields exposure seems to be not adequate for protecting people from the hazardous effects of the field.

Childhood Leukemia and Primary Prevention

Leukemia is the most common pediatric cancer, affecting 3800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia-usually before 5 years of age-and the presence at birth of "pre-leukemic" genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature-in the United States and internationally-that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the preconception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors-including pooled analyses from around the world and systematic reviews-is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children's health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgment until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.

Effects of simultaneous combined exposure to CDMA and WCDMA electromagnetic fields on serum hormone levels in rats

Despite more than a decade of research on the endocrine system, there have been no published studies about the effects of concurrent exposure of radiofrequency electromagnetic fields (RF-EMF) on this system. The present study investigated the several parameters of the endocrine system including melatonin, thyroid stimulating hormone, stress hormone and sex hormone after code division multiple access (CDMA, 849 MHz) and wideband code division multiple access (WCDMA, 1.95 GHz) signals for simultaneous exposure in rats. Sprague-Dawley rats were exposed to RF-EMF signals for 45 min/day, 5 days/week for up to 8 weeks. The whole-body average specific absorption rate (SAR) of CDMA or WCDMA was 2.0 W/kg (total 4.0 W/kg). At 4 and 8 weeks after the experiment began, each experimental group's 40 rats (male 20, female 20) were autopsied. Exposure for 8 weeks to simultaneous CDMA and WCDMA RF did not affect serum levels in rats of melatonin, thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxin (T4), adrenocorticotropic hormone (ACTH) and sex hormones (testosterone and estrogen) as assessed by the ELISA method.

Alternative medicine techniques have non-linear effects on radiation response and can alter the expression of radiation induced bystander effects

Many so-called "alternative medicine" techniques such as Reiki and acupuncture produce very good outcomes for intractable pain and other chronic illnesses but the efficacy is often dismissed as being psychosomatic. However a plausible mechanism does exist i.e. that the treatments alter the electromagnetic fields in living organisms and thereby prevent or reduce activity of neurons which lead to the pain. Low doses of ionising radiation have similar effects on electromagnetic fields and are known to induce signaling cascades in tissues due to ion gradients. To test this hypothesis cell cultures were exposed to Reiki - like and to acupuncture - like treatments, both performed by qualified practitioners. The cells were exposed either before or after the treatment to x-rays and were monitored for production of direct damage or bystander signals. The data suggest that the alternative techniques altered the response of cells to direct irradiation and altered bystander signal mechanisms. We conclude that alternative medicine techniques involving electromagnetic perturbations may modify the response of cells to ionizing radiation. In addition to the obvious implications for mechanistic studies of low dose effects, this could provide a novel target to exploit in radiation protection and in optimizing therapeutic gain during radiotherapy.

A population-based case-control study of radiofrequency exposure in relation to childhood neoplasm

This population-based case-control study in Taiwan considered incident cases aged 15 years or less and admitted in 2003 to 2007 for all neoplasm (ICD-9-CM: 140-239) (n=2606), including 939 leukemia and 394 brain neoplasm cases. Controls were randomly selected, with a case/control ratio of 1:30 and matched on year of birth, from all non-neoplasm children insured in the same year when the index case was admitted. Annual summarized power (ASP, watt-year) was calculated for each of the 71,185 mobile phone base stations (MPBS) in service between 1998 and 2007. Then, the annual power density (APD, watt-year/km(2)) of each township (n=367) was computed as a ratio of the total ASP of all MPBS in a township to the area of that particular township. Exposure of each study subject to radio frequency (RF) was indicated by the averaged APD within 5 years prior to the neoplasm diagnosis (cases) or July 1st of the year when the index case was admitted (controls) in the township where the subject lived. Unconditional logistic regression model with generalized estimation equation was employed to calculate the covariate-adjusted odds ratio [AOR] of childhood neoplasm in relation to RF exposure. A higher than median averaged APD (approximately 168 WYs/km(2)) was significantly associated with an increased AOR for all neoplasms (1.13; 1.01 to 1.28), but not for leukemia (1.23; 0.99 to 1.52) or brain neoplasm (1.14, 0.83 to 1.55). This study noted a significantly increased risk of all neoplasms in children with higher-than-median RF exposure to MPBS. The slightly elevated risk was seen for leukemia and brain neoplasm, but was not statistically significant. These results may occur due to several methodological limitations.

Is newborn melatonin production influenced by magnetic fields produced by incubators?

BACKGROUND

During permanence in most incubators, newborns are very close to the electric engine, which represents a source of electromagnetic fields (EMF). Previous studies demonstrated a decrease in melatonin production in adults and animals exposed to EMF.

AIMS

To assess melatonin production in a group of newborns exposed to EMF, and to evaluate whether removing the babies from the source of MF can affect melatonin production.

STUDY DESIGN AND SUBJECTS

We have recruited 28 babies (study group), who had spent at least 48 h in incubator where we had previously assessed the presence of significant EMF. We have measured their mean 6-hydroxy-melatonin-sulfate (6OHMS) urine excretion at the end of their permanence in the incubators, and compared it with their mean 6OHMS excretion after having been put in cribs, where EMF are below the detectable limit (<0.1mG). We have also measured urine 6OHMS twice, with an interval of 48h, in a control group of 27 babies who were not exposed to EMF during both samples.

RESULTS

Mean 6OHMS/cr values were respectively 5.34±4.6 and 7.68±5.1ng/mg (p=0.026) when babies were exposed to EMF in incubators, and after having been put in the crib. In the control group, mean 6OHMS/cr values in the first and in the second sample were respectively 5.91±5.41 vs 6.17±3.94ng/mg (p=0.679).

CONCLUSIONS

The transitory increase in melatonin production soon after removing newborns from incubators demonstrates a possible influence of EMF on melatonin production in newborns. Further studies are needed to confirm these data.

Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects

Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.

A case-case study of mobile phone use and acoustic neuroma risk in Japan

Results of case-control studies of mobile phone use and acoustic neuroma have been inconsistent. We conducted a case-case study of mobile phone use and acoustic neuroma using a self-administered postal questionnaire. A total of 1589 cases identified in 22 hospitals throughout Japan were invited to participate, and 787 cases (51%) actually participated. Associations between laterality of mobile phone use prior to the reference dates (1 and 5 years before diagnosis) and tumor location were analyzed. The overall risk ratio was 1.08 (95% confidence interval (CI), 0.93-1.28) for regular mobile phone use until 1 year before diagnosis and 1.14 (95% CI, 0.96-1.40) for regular mobile phone use until 5 years before diagnosis. A significantly increased risk was identified for mobile phone use for >20 min/day on average, with risk ratios of 2.74 at 1 year before diagnosis, and 3.08 at 5 years before diagnosis. Cases with ipsilateral combination of tumor location and more frequently used ear were found to have tumors with smaller diameters, suggesting an effect of detection bias. Furthermore, analysis of the distribution of left and right tumors suggested an effect of tumor-side-related recall bias for recall of mobile phone use at 5 years before diagnosis. The increased risk identified for mobile phone users with average call duration >20 min/day should be interpreted with caution, taking into account the possibilities of detection and recall biases. However, we could not conclude that the increased risk was entirely explicable by these biases, leaving open the possibility that mobile phone use increased the risk of acoustic neuroma.

"Dirty electricity": what, where, and should we care?

Environmental exposure to high-frequency voltage transients (HFVT), also termed dirty electricity, has been advocated among electro(hyper)sensitive interest groups as an important biological active component of standard electromagnetic pollution. A literature search was conducted in PubMed, in which only seven articles were identified. Exposure to HFVT was associated with increased cancer risks, while preferential removal of 4-100 kHz HFVT from 50-60 Hz ELF circuits was linked to a variety of improvements in health (plasma glucose levels in diabetic patients, symptoms of multiple sclerosis, asthma and other respiratory illnesses, and insomnia), well-being (tiredness, frustration, general health, irritation, sense of satisfaction, mood), and student behavior. However, all these published studies were subject to significant methodological flaws in the design of the studies, the assessment of exposure, and the statistical analysis, which prevented valid assessment of a causal link between this exposure metric and adverse effects. Environmental exposure to HFVT is an interesting EMF exposure metric, which might explain the spurious results from epidemiological studies using 'standard' ELF and RF exposure metrics. However, at present, methodological problems in published studies prohibit the valid assessment of its biological activity.

Mobile phone base stations and early childhood cancers: case-control study

OBJECTIVE

To investigate the risk of early childhood cancers associated with the mother's exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy.

DESIGN

Case-control study.

SETTING

Cancer registry and national birth register data in Great Britain.

PARTICIPANTS

1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case).

MAIN OUTCOME MEASURES

Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin's lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing.

RESULTS

Mean distance of registered address at birth from a macrocell base station, based on a national database of 76,890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (-30.3 (SD 21.7) dBm v -29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin's lymphoma (P=0.51 for trend).

CONCLUSIONS

There is no association between risk of early childhood cancers and estimates of the mother's exposure to mobile phone base stations during pregnancy.

Risk of hematological malignancies associated with magnetic fields exposure from power lines: a case-control study in two municipalities of northern Italy

BACKGROUND

Some epidemiologic studies have suggested an association between electromagnetic field exposure induced by high voltage power lines and childhood leukemia, but null results have also been yielded and the possibility of bias due to unmeasured confounders has been suggested.

METHODS

We studied this relation in the Modena and Reggio Emilia municipalities of northern Italy, identifying the corridors along high voltage power lines with calculated magnetic field intensity in the 0.1-<0.2, 0.2-<0.4, and > or = 0.4 microTesla ranges. We identified 64 cases of newly-diagnosed hematological malignancies in children aged <14 within these municipalities from 1986 to 2007, and we sampled four matched controls for each case, collecting information on historical residence and parental socioeconomic status of these subjects.

RESULTS

Relative risk of leukemia associated with antecedent residence in the area with exposure > or = 0.1 microTesla was 3.2 (6.7 adjusting for socioeconomic status), but this estimate was statistically very unstable, its 95% confidence interval being 0.4-23.4, and no indication of a dose-response relation emerged. Relative risk for acute lymphoblastic leukemia was 5.3 (95% confidence interval 0.7-43.5), while there was no increased risk for the other hematological malignancies.

CONCLUSIONS

Though the number of exposed children in this study was too low to allow firm conclusions, results were more suggestive of an excess risk of leukemia among exposed children than of a null relation.